| NPI | 1952072043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON M BASS Manager 502-562-0398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2021-09-28 |